MODULE 16 short answer questions.

saq 1.

A 36 year old woman with a history of chronic thyroid disease presents to the emergency room with confusion and a productive cough. Her vital signs are:

HR 65 /minBP 87/70 mmHgT 33.8 oCRR 15 /minSats 99% RAGCS 7

Initial pathology is shown below.

Free T4 0.12 pmol/LTSH 0.01 mU/L

Question 1. (3 marks)

What is the diagnosis? Give 2 complicating diagnoses which should be considered?

Question 2. (4 marks)

Give 4 interventions you will undertake for this patient.

Question 3. (3 marks)

Give 3 indications for ICU admission for this patient.

saq 2.

A 10 year old patient presents with his mother with a reduced level of consciousness. He has developed respiratory distress over the course of the day, and she is convinced that his asthma has “flared up”.

His vital signs on arrival to the emergency department are:

HR 145 /min

BP 91/60 mmHg

RR 42 /min

Sats 99% RA

T 37.2 oC

GCS 10

Urgent arterial blood gas analysis is performed and the results are shown below.

What are the two major acid base abnormalities on the ABG? Which is the primary disturbance?

Question 2. (2 marks)

Calculate a derived value that allows you to interpret the primary disturbance.

Question 3. (1 mark)

What is the most likely diagnosis?

Question 4. (2 marks)

Correct the Na and K for the derangements in the ABG.

Question 5. What critical intervention will you institute to manage this patient? (2 marks)

saq 3.

A 54 year old type two diabetic presents to your department after being found unconscious by his wife. She states that aside from the diabetes he has no major medical problems, but he has been complaining of dysuria for 2 days. On arrival his vital signs are:

Give 2 derived values from the electrolyte profile and the likely diagnosis.

Question 3. (6 marks)

Give 6 interventions you will undertake as part of your management.

saq 4.

A 28 year old girl presents to our department with acute confusion. She had been complaining of acute anterior neck pain for the prior 4 days, and has no other medical history of note. She had attended the department the previous evening and had blood drawn. She was subsequently discharged with a diagnosis of “neck strain”. On arrival she has the following vital signs:

HR 150 /minRR 26 /minBP 85/58 mmHgSats 99% RAT 39.7 oC

Question 1. (3 marks)

Select results from the previous evening’s presentation are presented below.

Free T4 26 pmol/LTSH 0.01 mU/L

What do they show, and what is the diagnosis on this presentation?

Question 2. (5 marks)

Give 5 interventions you will immediately apply

Question 3. (3 marks)

Give a brief outline of your approach to the quality control issues in this case.